brain treatment advice
REGISTER
The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

brain treatment advice

› Forums › General Melanoma Community › brain treatment advice

  • Post
    • March 23, 2018 at 5:58 pm
    bms941
    Participant

    Hello:

    After having a brain metastisis removed in January, the melanoma has returned to my dad's brain in the last few weeks. At this point, the suggested therapy by our main oncologist, neurosurgeons, and radiation oncologist is whole-brain radiation followed by temozolomide (Temodar). 

    Another oncologist we've consulted with suggested bevacizumab (Avastin) instead of the whole-brain radiation in an effort to maintain his quality of life, which this doctor felt would be impacted by the whole-brain radiotherapy. 

    Any opinions from the community on which way to proceed would be appreciated. 

Viewing 0 reply threads
  • Replies
      • March 23, 2018 at 6:10 pm
      Bubbles
      Participant

      Is your father being treated by a melanoma specialist?  Has he been on immunotherapy (ipi/Yervoy, Nivolumab/Opdivo, or Pembrolizumab/Keytruda)?  Is his melanoma BRAF postive?  If so, has he been treated with targeted therapy via a BRAF inhibitor combined with a MEK inhibitor?  Those are first line treatment options for melanoma…in the body or in the brain.  Radiation (via stereotactic radiation or gamma knife) can increase the benefit of immunotherapy tremendously.  Whole brain is generally not recommended for melanoma.  However, with limited knowledge of your dad's prior treatment and status, it is hard to make any recommendations.  Here is a basic primer on melanoma treatment:   http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/08/melanoma-intel-primer-for-current.html

      Here are posts that include studies/reports on the best ways to treat brain mets:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2018/03/concurrent-radiation-and-immunotherapy.html  

      With more info about what treatment your dad has already had, I'm sure others on this board can offer good advice.  I wish you and your dad my best.  celeste

        • March 23, 2018 at 6:39 pm
        bms941
        Participant

        Thanks Celeste. Yes, he is being treated by a melanoma specialist and has been since the fall of 2015, when the first mets was discovered and removed (in his esophagus). There were two more mets in 2017 (lung and stomach), which were both removed, then the brain met in January which, again, has now returned. 

        Not BRAF positive. 

        Yes, he has been on different immunotherapies since January 2016 including pembro and ipi and combinations thereof. 

        Thanks again for your response and advice. 

         

        • March 23, 2018 at 7:23 pm
        Bubbles
        Participant

        Okay.  Was afraid of that.  It gets tricky at this point, to say the least. I will think about it some more and hopefully others…esp Ed…will chime in with possible options.  If there is only one met in the brain…I would still try SRS or gamma knife as an option.  That way he gets helpful radiation to the returned met and could cont immunotherapy or immunotherapy with some of the new addtions like IDO, HDAC, or ERK inhibitors, anti-LAG3 or CD4 blockers.  Addtionally, if not already done more tumor typing may be helpful.  For instance, if you check out posts by Maureen038, you will find that her husband failed to respond to all sorts of melanoma therapies, but once his tumor was tested, it was found he had a HER-2 mutation and has responded very well to breast cancer drugs!!! 

        Hang in there.  Yours, celeste

Viewing 0 reply threads
  • You must be logged in to reply to this topic.
About the MRF Patient Forum

The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

Popular Topics